Wednesday, May 26, 2010

Mud or Rainbows?

Lately I've found myself facing some unique challenges. I've found that when these challenges come (and we all know that they always will!) that although I can't always control circumstances, I can choose to control how I respond.

This was clearly illustrated to me in the last week as we had quite a bit of rain. I slipped in the mud one day on my way home from work. I nearly ate it but got my balance just in time. Nevertheless my shoe and foot were rather muddied. As soon as I got home I grabbed the camera to document the moment.

Not long before the mud incident I had found the need to grab the camera to capture some amazing rainbows. With the rainy season we sure get a lot of mud. It can be a pain trying to get from point A to point B. But we also get some amazing rainbows. And the flora becomes lush and green with flowers blooming everywhere.

So it's occurred to me that I have the choice to focus on the mud or to focus on the rainbows. The same applies to challenges when they come our way. Will we see mud? Or will we look up and see the rainbows?

Monday, May 24, 2010

Just Another Day

Well today was just another day in the clinic. Nothing particularly outstanding or special. But I don't often write about what a typical day looks like. In many ways our walk-in clinic probably has some similarities to clinics in the USA.

There are the patients who you know will not take your advice unless it is in alignment with what they already had in mind. There are the patients who started self-medicating before they came to you. Because antibiotics can be purchased over-the-counter here that one can be a bit scary at times. Bactrim is the drug of choice for patients to take one or two doses and then come in a few days later because the medicine didn't work.

Today I was the only nurse in the treatment department. I have to say that my preference is to work alongside another nurse because I strongly believe that two brains are better than one. Especially with some of the crazy things we see. But thankfully I didn't see anything too scary today.

My first patient of the day didn't really want to be at the clinic. She had malaria and clearly felt horrible. I think she just wanted someone to pick up the medications and bring them home to her. She was refusing a physical exam, refusing lab tests, pretty much refusing everything but medicine. Fun stuff!

I made a referral this morning for a two-year-old who is severely developmentally delayed. The mom brought her in because she has a respiratory infection. But she hasn't walked yet, is cross-eyed and doesn't interact with people much.

My typhoid patient of the day was diagnosed at another clinic. The mother of the 10-year-old girl brought her lab results and the medicine they gave her a week ago. She hadn't improved so they wanted another opinion. Well sure enough she had typhoid, unfortunately they were giving her antibiotics for a skin infection. So we started her on a new medicine and hopefully she will turn around quickly.

I had a 19-year-old girl who is finishing HS at a boarding school. She has a menstrual problem and is really embarrassed about her teachers and peers knowing about what she is being treated for.

My toughest case so far today was the three-year old with the third-degree burns on her hand. They aren't fresh burns but she has to come regularly for wound care. I had to pull of some of the dead skin before putting on a fresh dressing. The sweetie is a little trooper. Trembling all over and tears rolling down her face she holds up her hand to me to begin debrieding. I was wishing I had stickers to put over the bandage when I was done.

And the funniest case of the day was the old-man (that is a respectful term here) with the chronic ulcer on his ankle. So the ulcer wasn't the funny part. The funny part was that he told me "I'm here to get my dressing changed from my snake bite." I asked him when he had the snake bite and he told me "1950, and it's doing much better now than it was then!"

Just another day in the clinic. Thank you Lord for giving me this opportunity to reach into people's lives when they are at their most vulnerable. Please use me to make a difference in the lives of each patient I encounter this week....

Wednesday, May 19, 2010

On Loss

I'm wanting to share about some of the events of this past week but I'm not really sure where to start. I think I've told you a bit in the past about Living Room Ministries (LRM), an organization headed up by my friend Juli. Her hospice building is located between my home and the clinic, literally steps from both my house and the clinic. So even though I'm not an official part of the LRM team I find myself regularly getting involved.

This past week one of William's relatives was admitted to LRM for hospice care. So I've been even more involved than usual. After spending several days in the local government hospital, it was finally determined that his cancer had spread to several key organs and was untreatable. Hospice was recommended. So he came home to The Living Room.

Since his admission I've been consulted on his care and have assisted with several treatments (including the placing of a nasal-gastric tube and syringe-suctioning his stomach contents).

On Saturday one of the family members came to share the salvation message with this man. It was a precious time as both he and his roommate, a precious old man, prayed a sinners prayer in their mother tongue.

This morning he went to be with the Lord. It happened sooner than we expected, but he went peacefully. As the news began to break, the air was filled with the sound of screams of agony and cries of anguish. You see, Kenyans may not be very emotive most of the time, but when it comes to death they grieve hard and fast. It's normal to see women falling on the ground or even going into a catatonic state upon receiving the news that a loved one has died.

It was quickly determined that it was not in the best interest of the other patients to witness the family's demonstration of grief. So the family were relocated to our home. Today we have had dozens of relatives pass by our home to share together in this time of grief. The relative who has passed away is actually from a village a number of hours from here. So William has gone with some of the closest relatives to go break the news to the friends and family in his home village. The home burial will likely take place at his home in a few days. Please join me in praying that Christ's light will shine brightly in our lives during this time of pain and loss for William's family.

Tuesday, May 18, 2010

Food Poisoning

Yesterday was my first full day back to the clinic after two weeks of being gone for my PMTCT class. As I approached the clinic I quickly noticed a group of people sitting on the benches outside. It's pretty unusual for us to have patients when we open at 8AM. They usually start flowing in around 9:30 after taking care of the kids, and farm/home issues.

Well it seems that one of the dormitories for the ELI boarding school had contracted food poisoning. We had 25 girls with "it" coming out both ends. Definitely a handful! No, make that two handfuls! One of the girls had malaria on top of the food poisoning. A few were so dehydrated that they needed IV fluids.

I'm convinced that somebody snuck some sort of snack food into the dorm. Because the symptoms were very classic food poisoning and were very isolated to the one dorm. None of the boys or children from the children's home were affected.

As the day progressed a few girls were carried to the clinic from the local public school. As I saw them coming my first thought was "Oh no, this is not food poisoning, but some sort of an epidemic!" But thankfully the two girls from Chebaiywa had malaria and a different set of symptoms from all of our Brook of Faith girls. This morning we were able to discharge our last malaria and food poisoning patients from yesterdays madness.

I'm hoping for a slower day today and a chance to finish catching up on the admin stuff for the last two weeks. At the moment the sun is shining and the day looks good!

Wednesday, May 12, 2010


For this week and last I've been in a course called "Preventing Mother To Child Transmission" or more simply, PMTCT. And it has been quite a class! When the Ministry of Health first called me and invited me to come I thought it was going to be a one-day seminar. I was a bit surprised to learn that it was an 80hr course crammed into two weeks.

I have been boarding at the church guest house where the class is being held. I could write an entire blog just about my boarding experience. Maybe later when I don't have homework!

The class has covered everything from a review of midwifery (yes it is expected that everyone in the class regularly delivers babies!) to the pathophsyiology of HIV, to counseling couples when one tests positive and the other is negative, to the medications you put an exposed newborn on. I'm the only mzungu (white person) in the class. It has been a blast making friends with other health professionals from our region.

I think the best part has been the class discussions. It has been so refreshing to hear Kenyan healthcare providers verbalize things that have strongly been on my heart and mind. As an American outsider I often have to hold my tongue when I see what I would consider to be problems within the culture. But this week I heard Kenyan men and women stand up and say "Just because this is part of our culture does NOT make it right." There were a lot of stimulating conversations about how to bring about change.

Ive also got some great potentials for networking. I have a passion for women's healthcare. It drives me crazy that most women in Kenya don't know what a Pap smear is, let alone have ever had one. I have talked for the last two years about investigating the possibility of launching some sort of screening and treatment program for cervical cancer. Through the PMTCT course I have gotten some phone numbers of key individuals that may be able to give me some pointers and connect me with others who are like-minded. Hopefully something will come of it. I will keep you posted!